title: Diabetes mortality in Panama and related biological and socioeconomic risk factors.
abstract: OBJECTIVE
  To estimate mortality from diabetes mellitus (DM) for the period 2001-2011 in the Republic of Panama, by province/indigenous territory, and determine its relationship with biological and socioeconomic risk factors.
  
  
  METHODS
  Cases for the years 2001-2011 with DM listed as the principal cause of death were selected from Panama's National Mortality Registry. Crude and adjusted mortality rates were generated by sex, age, and geographic area. Linear regression analyses were performed to determine the relationship between DM mortality and biological and socioeconomic risk factors. A composite health index (CHI) calculated from biological and socioeconomic risk factors was estimated for each province/indigenous territory in Panama.
  
  
  RESULTS
  DM mortality rates did not increase for men or women during 2001-2011. Of the biological risk factors, being overweight had the strongest association with DM mortality. Of the socioeconomic risk factors, earning less than US$ 100 per month had the strongest association with DM mortality. The highest socioeconomic CHI scores were found in a province that is predominantly rural and in areas with indigenous populations. The highest biological CHI scores were found in urban-rural provinces and those with the highest percentage of elderly people.
  
  
  CONCLUSIONS
  Regional disparities in the association between DM mortality and DM risk factors reaffirm the heterogeneous composition of the Panamanian population and the uneven distribution of biological and social determinant risk factors in the country and point to the need to vary management strategies by geographic area for this important cause of disability and death in Panama.
authors.affiliation: Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama, mensajesjorgemotta@gmail.com.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Motta
authors.forename: Luis G
authors.initials: LG
authors.lastname: Ortega-Paz
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Gordón
authors.forename: Beatriz
authors.initials: B
authors.lastname: Gómez
authors.forename: Eva
authors.initials: E
authors.lastname: Castillo
authors.forename: Víctor
authors.initials: V
authors.lastname: Herrera Ballesteros
authors.forename: Manuel
authors.initials: M
authors.lastname: Pereira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000208:ethnology / Q000401:mortality*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D007197:Indians, Central American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology; D010176:Panama / Q000453:epidemiology; D011203:Poverty; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D062206:Spatial Analysis; D014505:Urban Population